University of Córdoba study of 217 finds perceived health-care discrimination associated with delayed appointments among LGBTQIA+ young adults

Researchers Andrea Miranda, Judith Velasco and Francisco Javier Sanmartín at the University of Córdoba surveyed 217 adults aged 18 to 40 and interviewed 23 in depth. The study, published in Archives of Sexual Behavior, asked whether sexual and gender minority young adults perceived more discrimination in health care than cisgender people and whether that perception affected trust and appointment attendance. The quantitative data showed gay, bisexual, lesbian and trans participants reported higher rates of perceived discrimination, while cisgender participants also reported some discrimination.

The interviews identified specific harms: trans participants reported use of deadnames and incorrect pronouns despite explicit requests, while gay, lesbian and bisexual participants reported moral judgment, paternalism and assumptions about promiscuity. The researchers linked perceived discrimination to psychological distress and lower trust in clinicians. They also reported that participants delayed consultations or concealed sexual orientation or gender identity, which the study associated with possible misdiagnosis, less effective treatment and worse prognoses.

The findings fit a broader pattern in which minority stress and health-system mistrust can turn everyday clinical encounters into barriers. When patients expect invalidation, they may withhold information, avoid routine care or seek care only when symptoms become severe. The researchers attributed the problem not to deliberate hostility by clinicians but to insufficient training and outdated protocols, suggesting university curricula should include sensitivity content across subjects to support individualized care.

The study matters because delayed care can worsen outcomes for conditions that are easier to treat when caught early, and because concealment can compromise clinical judgment. Its evidence is associative and based on a Spanish sample of 217 young adults, with qualitative interviews adding depth but not measuring actual appointments or diagnoses. The design cannot prove discrimination caused delays, but it identifies a plausible pathway: perceived discrimination reduces trust, trust affects care-seeking, and care-seeking affects health.